Table: Some Drugs Used to Treat Arrhythmias-MSD Manual Consumer Version

Some Drugs Used to Treat Arrhythmias

Examples	Some Side Effects	Comments
Beta-blockers
	An abnormally slow heart rate (bradycardia) Fatigue Depression Possible masking of low blood sugar levels Impaired circulation in the trunk, arms, and legs Insomnia Raynaud syndrome Sexual dysfunction Shortness of breath Spasm of the airways (bronchospasm) With some beta-blockers, an increase in the triglyceride (a fat) level In people with glaucoma, increased pressure in the eye	These drugs are used to treat ventricular premature beats, ventricular tachycardia, ventricular fibrillation, and paroxysmal supraventricular tachycardia. They are also used to slow the ventricular rate (how fast the heart's lower chambers—the ventricles—beat) in people with atrial fibrillation or atrial flutter. People who have asthma should ask their doctor before taking these drugs.
Calcium channel blockers
	Constipation Diarrhea Low blood pressure Swollen feet	Only certain calcium channel blockers, such as diltiazem and verapamil, are useful for arrhythmias. They are used to slow the ventricular rate in people who have atrial fibrillation or atrial flutter and to treat paroxysmal supraventricular tachycardia. Diltiazem and verapamil slow the conduction of electrical impulses through the atrioventricular node. Certain people with Wolff-Parkinson-White syndrome

	Nausea Vomiting Serious arrhythmias If the dose is too high, distortion of color vision, making objects appear greenish yellow	Digoxin slows conduction of electrical impulses through the atrioventricular node. Digoxin is used to decrease the ventricular rate in people who have atrial fibrillation or atrial flutter and to treat paroxysmal supraventricular tachycardia.
Potassium channel blockers
Azimilide Vernakalant	For all potassium channel blockers: Arrhythmias and low blood pressure	These drugs are used to treat ventricular premature beats, ventricular tachycardia, ventricular fibrillation, atrial fibrillation, and atrial flutter. Because amiodarone can be toxic, it is used for long-term treatment only in some people who have serious or very bothersome arrhythmias. Bretylium is used only for short-term treatment of life-threatening ventricular tachycardias. Azimilide and vernakalant are not available in the United States.
Purine nucleoside
	Spasm of the airways Flushing (for a short time)	Adenosine slows conduction of electrical impulses through the atrioventricular node. Adenosine is used to end episodes of paroxysmal supraventricular tachycardia. People who have asthma are not given this drug.
Sodium channel blockers
	Arrhythmias (which can be fatal, particularly in people who have a heart disorder) For some drugs: Digestive upset Dizziness Dry mouth Light-headedness Retention of urine Tremor In people with glaucoma, increased pressure in the eyes	These drugs slow the conduction of electrical impulses through the heart. These drugs are used to treat ventricular premature beats, ventricular tachycardia, and ventricular fibrillation and to convert atrial fibrillation or atrial flutter to normal rhythm (cardioversion). Except for lidocaine and mexiletine, these drugs may also be used to prevent episodes of atrial fibrillation or atrial flutter and, less commonly, paroxysmal supraventricular tachycardia.

Examples

Some Side Effects

Comments

Beta-blockers

An abnormally slow heart rate (bradycardia)

Fatigue

Depression

Possible masking of low blood sugar levels

Impaired circulation in the trunk, arms, and legs

Insomnia

Raynaud syndrome

Sexual dysfunction

Shortness of breath

Spasm of the airways (bronchospasm)

With some beta-blockers, an increase in the triglyceride (a fat) level

In people with glaucoma, increased pressure in the eye

These drugs are used to treat ventricular premature beats, ventricular tachycardia, ventricular fibrillation, and paroxysmal supraventricular tachycardia. They are also used to slow the ventricular rate (how fast the heart's lower chambers—the ventricles—beat) in people with atrial fibrillation or atrial flutter.

People who have asthma should ask their doctor before taking these drugs.

Calcium channel blockers

Constipation

Diarrhea

Low blood pressure

Swollen feet

Only certain calcium channel blockers, such as diltiazem and verapamil, are useful for arrhythmias. They are used to slow the ventricular rate in people who have atrial fibrillation or atrial flutter and to treat paroxysmal supraventricular tachycardia.

Diltiazem and verapamil slow the conduction of electrical impulses through the atrioventricular node.

Certain people with Wolff-Parkinson-White syndrome

Nausea

Vomiting

Serious arrhythmias

If the dose is too high, distortion of color vision, making objects appear greenish yellow

Digoxin slows conduction of electrical impulses through the atrioventricular node. Digoxin is used to decrease the ventricular rate in people who have atrial fibrillation or atrial flutter and to treat paroxysmal supraventricular tachycardia.

Potassium channel blockers

Azimilide

Vernakalant

For all potassium channel blockers: Arrhythmias and low blood pressure

These drugs are used to treat ventricular premature beats, ventricular tachycardia, ventricular fibrillation, atrial fibrillation, and atrial flutter.

Because amiodarone can be toxic, it is used for long-term treatment only in some people who have serious or very bothersome arrhythmias.

Bretylium is used only for short-term treatment of life-threatening ventricular tachycardias.

Azimilide and vernakalant are not available in the United States.

Purine nucleoside

Spasm of the airways

Flushing (for a short time)

Adenosine slows conduction of electrical impulses through the atrioventricular node.

Adenosine is used to end episodes of paroxysmal supraventricular tachycardia.

People who have asthma are not given this drug.

Sodium channel blockers

Arrhythmias (which can be fatal, particularly in people who have a heart disorder)

For some drugs:

Digestive upset

Dizziness

Dry mouth

Light-headedness

Retention of urine

Tremor

In people with glaucoma, increased pressure in the eyes

These drugs slow the conduction of electrical impulses through the heart.

These drugs are used to treat ventricular premature beats, ventricular tachycardia, and ventricular fibrillation and to convert atrial fibrillation or atrial flutter to normal rhythm (cardioversion).

Except for lidocaine and mexiletine, these drugs may also be used to prevent episodes of atrial fibrillation or atrial flutter and, less commonly, paroxysmal supraventricular tachycardia.